Mysterious blood clots are COVID-19's latest lethal surprise

News Network
April 28, 2020

Washington, Apr 28: After nearly three weeks in an intensive care unit in Los Angeles, doctors treating 41-year-old Broadway actor Nick Cordero for COVID-19 were forced to amputate his right leg.

The flow of blood had been impeded by a blood clot: yet another dangerous complication of the disease that has been bubbling up in frontline reports from China, Europe and the United States.

To be sure, so-called "thrombotic events" occur for a variety of reasons among intensive care patients, but the rates among COVID-19 patients are far higher than would be otherwise expected.

"I have had 40-year-olds in my ICU who have clots in their fingers that look like they'll lose the finger, but there's no other reason to lose the finger than the virus," Shari Brosnahan, a critical care doctor at NYU Langone said.

One of these patients is suffering from a lack of blood flow to both feet and both hands, and she predicts an amputation may be necessary, or the blood vessels may get so damaged that an extremity could drop off by itself.

Blood clots aren't just dangerous for our limbs, but can make their way to the lungs, heart or brain, where they may cause lethal pulmonary embolisms, heart attacks, and strokes.

A recent paper from the Netherlands in the journal Thrombosis Research found that 31 percent of 184 patients suffered thrombotic complications, a figure that the researchers called "remarkably high" -- even if extreme consequences like amputation are rare.

Behnood Bikdeli, a doctor at New York-Presbyterian Hospital, assembled an international consortium of experts to study the issue. Their findings were published in the Journal of The American College of Cardiology.

The experts found the risks were so great that COVID-19 patients "may need to receive blood thinners, preventively, prophylactically," even before imaging tests are ordered, said Bikdeli.

What exactly is causing it? The reasons aren't fully understood, but he offered several possible explanations.

People with severe forms of COVID-19 often have underlying medical conditions like heart or lung disease -- which are themselves linked to higher rates of clotting.

Next, being in intensive care makes a person likelier to develop a clot because they are staying still for so long. That's why for example people are encouraged to stretch and move around on long haul flights.

It's also now clear the COVID-19 illness is associated with an abnormal immune reaction called "cytokine storm" -- and some research has indicated this too is linked to higher rates of clotting.

There could also be something about the virus itself that is causing coagulation, which has some precedent in other viral illnesses.

A paper in the journal The Lancet last week showed that the virus can infect the inner cell layer of organs and of blood vessels, called the endothelium. This, in theory, could interfere with the clotting process.

According to Brosnahan, while thinners like Heparin are effective in some patients, they don't work for all patients because the clots are at times too small.

"There are too many microclots," she said. "We're not sure exactly where they are."

Autopsies have in fact shown some people's lungs filled with hundreds of microclots.

The arrival of a new mystery however helps solve a slightly older one.

Cecilia Mirant-Borde, an intensive care doctor at a military veterans hospital in Manhattan, told AFP that lungs filled with microclots helped explain why ventilators work poorly for patients with low blood oxygen.

Earlier in the pandemic doctors were treating these patients according to protocols developed for acute respiratory distress syndrome, sometimes known as "wet lung."

But in some cases, "it's not because the lungs are occupied with water" -- rather, it's that the microclotting is blocking circulation and blood is leaving the lungs with less oxygen than it should.

It has just been a little under five months since the virus emerged in Wuhan, China, and researchers are learning more about its impact every day.

"While we react surprised, we shouldn't be as surprised as we were. Viruses tend to do weird things," said Brosnahan.

While the dizzying array of complications may seem daunting, "it's possible there'll be one or a couple of unifying mechanisms that describe how this damage happens," she said.

"It's possible it's all the same thing, and that there'll be the same solution."

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coastaldigest.com web desk
June 18,2020

Kathmandu, June 18: Nepal's National Assembly on Thursday unanimously passed the Constitution Amendment Bill to update the country's political and administrative map incorporating three Indian territories. 

The new map also includes land controlled by India. It requires President Bidhya Devi Bhandari's approval.

India, which controls the region - a slice of land including Limpiyadhura, Lipulekh and Kalapani areas in the northwest - has rejected the map, saying it is not based on historical facts or evidence.

India has termed as untenable the "artificial enlargement" of territorial claims by Nepal after its lower house of parliament on Saturday unanimously approved the new political map of the country featuring areas which India maintains belong to it.

The National Assembly, or the upper house of the Nepalese parliament, unanimously passed the constitution amendment bill providing for inclusion of the country's new political map in its national emblem.

The bill was passed with all the 57 members present voting in its favour.

The dispute

The latest border dispute between the countries began last month after India inaugurated Himalayan link road built in a disputed region that lies at a strategic three-way junction with Tibet and China.

The 80km (50-mile) road, inaugurated by Indian Defence Minister Rajnath Singh, cuts through the Lipulekh Himalayan pass, considered one of the shortest and most feasible trade routes between India and China.

The road cuts the travel time and distance from India to Tibet's Mansarovar lake, considered holy by the Hindus.

But Nepal says about 19km of the road passes through its area and fiercely contested the inauguration of the road, viewing the alleged incursion as a stark example of bullying by its much larger neighbour.

Nepal, which was never under colonial rule, has long claimed the areas of Limpiyadhura, Kalapani and Lipulekh under the 1816 Sugauli treaty with the British East India Company, although these areas have remained under the control of Indian troops since India fought a war with China in 1962.

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Angry indian
 - 
Sunday, 21 Jun 2020

acche din after deshbakth become ruling party...now even weakist country started conquring indian..what a shame on so0 called 56 inch chest..we need tiger leader not Pm who always speak in air and lie alot..

 

this is how an hindu nation is build ? Bjps cant rule india for more than 10 year...

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Agencies
February 26,2020

Islamabad, Feb 26: Islamabad on Tuesday declared former Prime Minister Nawaz Sharif an absconder while simultaneously denying extending bail to him.

The federal cabinet presided over by Prime Minister Imran Khan, cited that Sharif failed to provide required medical reports and has violated the bail terms.

The government has also decided to freeze gas and electricity tariffs for the next four months, The Dawn reported.

"After Nawaz Sharif failed to submit his medical report of any hospital in London, the medical board rejected a medical certificate sent by him and [the government] declared him an absconder. From today, Nawaz Sharif is an absconder according to the law of land and if he does not return to the country he will be declared a proclaimed offender," said Dr Firdous Ashiq Awan, Special Assistant to the Prime Minister on Information, in a press conference.

She further asserted that the Punjab government, which was authorized by the Islamabad High Court (IHC) to decide Sharif's case on medical grounds, had written several letters asking him to submit his medical report from any hospital in London. However, he failed to do so and only sent a certificate that was not accepted by the medical board.

"If he (Nawaz Sharif) is seriously ill then why a comprehensive medical report is not being submitted to the medical board," Firdous added.

Further, she said that the office of the opposition leader was also waiting for his younger brother and Leader of the Opposition in the National Assembly Shahbaz Sharif, who was also staying in London for 'no reason'.

"He is getting a monthly salary and enjoying luxurious offices and other perks and privileges but not performing his duties required by his office and the people. Shahbaz Sahib, return to the country and justify your salary and other benefits being given from taxpayers' money," Firdous added.

On October 29 last year, the IHC granted bail for eight weeks to Sharif, who was convicted and disqualified in corruption cases, on medical grounds.

Sharif left Pakistan for London along with Shahbaz on November 19, 2019, for his medical treatments there.

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News Network
June 4,2020

New York, Jun 4: The Minneapolis police officer who used his knee to pin down George Floyd's neck before his death was the most experienced of the four officers involved in the arrest, with a record that included medals for bravery and 17 complaints against him, including one for pulling a woman out of her car during a speeding stop.

New details about Derek Chauvin and the other now-fired officers emerged Wednesday after prosecutors upgraded Chauvin's charge to second-degree murder and charged the others with aiding and abetting in a case that has convulsed the nation with protests over race and police brutality.

Heavily redacted personnel files show that Chauvin, a 19-year veteran of the force, was initially trained as a cook and served in the Army as a military police officer.

Eleven-year veteran and native Hmong speaker Tou Thao began as a community service officer and was the subject of six complaints.

The other two officers were relative newcomers to the department, including Thomas Lane, a former juvenile detention guard who did volunteer work with Somali refugees, and J. Alexander Kueng, who got his start in law enforcement by patrolling his college campus and a department store.

The files were notable for what they didn't include. Only one of the 17 complaints against Chauvin was detailed, none of the six against Thao were mentioned and there was no further detail about a 2017 excessive force lawsuit against Thao.

Records show that the 44-year-old Chauvin initially studied cooking before taking courses in law enforcement and doing two stints in the Army as a military police officer in the late 1990s, serving at Fort Benning, Georgia, and in Germany.

Chauvin became a Minneapolis police officer in 2001 and the lone reprimand in his file involved a 2007 incident when he was accused of pulling a woman out of her car after stopping her for going 10 mph (16 kph) over the speed limit.

Investigators found it was not necessary for Chauvin to remove the woman from the car and noted that his squad car video was turned off during the stop.

But Chauvin was also singled out for bravery. Files show he won two medals of valor, one in 2006 for being part of a group of officers who opened fire on a stabbing suspect who pointed a shotgun at them, and another in 2008 for a domestic violence incident in which Chauvin broke down a bathroom door and shot a suspect in the stomach.

He also won medals of commendation in 2008 after he and his partner tackled a fleeing suspect who had a pistol in his hand, and in 2009 for single-handedly apprehending a group of gang members while working as an off-duty security guard at the El Nuevo Rodeo, a Minneapolis nightclub.

Since his arrest, the former owner of the club, Maya Santamaria, said Chauvin and Floyd both worked as security guards there at various times but that she wasn't sure if they had known one another.

She said Chauvin was unnecessarily aggressive on nights when the club had a black clientele, quelling fights by dousing the crowd with pepper spray and calling in several police squad cars as backup, a tactic she called “overkill.”

Chauvin's wife, Kellie, a Laotian immigrant who became the first Hmong winner of the Mrs. Minnesota pageant, said shortly after his arrest last week that she intends to divorce him.

Before news of the upgraded charges, an attorney for Chauvin said he was not making any statements at this time. Lawyers for the others did not return messages seeking comment.

In cellphone video of the May 25 arrest of Floyd, Chauvin is shown pressing his knee onto Floyd's neck for more than eight minutes while Floyd cries out “I can't breathe” and eventually stops moving.

During much of the arrest, Kueng and Lane were helping Chauvin restrain Floyd. Thao was standing nearby keeping onlookers back.

According the complaint, at one point during the arrest, as Chauvin held Floyd down with his knee, Lane asked Chauvin twice whether they should roll Floyd over.

“No, staying put where we got him,” Chauvin replied, “I am worried about excited delirium or whatever,” Lane said. And Chauvin replied again, “That's why we have him on his stomach.” None of the three officers moved from their positions.

Lane joined the police early last year as a 35-year-old cadet — much older than most rookies — and became a full-fledged officer last December. He had no complaints in his file during his short time on the force.

On employment forms, the University of Minnesota graduate said he done volunteer work tutoring Somali youth and as a mentor helping at-risk elementary school students with reading and homework.”

Kueng, at 26 the youngest of the four officers, was also a recent recruit to the police force. He completed his year's probation just three months before the Floyd arrest.

His personnel file, which notes that he speaks, reads and writes Russian, did not include any commendations or disciplinary actions during his short time on force.

Kueng was a 2018 graduate of the University of Minnesota, where he worked part-time as part of the campus security force. He also worked nearly three years as a theft-prevention officer at Macy's.

Thao joined the police force part-time in 2008 while attending a community college. Before that, he worked as a security guard, a supermarket stocker and trainer at McDonald's.

City records show six complaints were filed against Thao, but there was no mention of that in the records released Wednesday. There also was no mention of a 2017 federal lawsuit accusing him and another officer of excessive force.

According to the lawsuit, Lamar Ferguson claimed that in 2014, Thao and his partner stopped him and beat him up while he was on his way to his girlfriend's house. The lawsuit was settled for $25,000 ___

Richmond reported from Madison, Wisconsin. Associated Press writer Scott Bauer in Madison and researcher Rhonda Shafner in New York contributed to this report.

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